Lipo and Excision from nipple incision only

[artichokeheart]

I am scheduled for surgery in Shanghai, China later this month. I've put this off for so long that I just want to get it done, and I don't want to spend thousands atop thousands traveling back to the states.
Anyway, the surgeon instructed me in the consultation that he would remove all fat and gland from the areolar incision. Can the tumescent procedure be performed in this manner? Prior to the consult I was told that this surgeon was the best specialist in the hospital, but he didn't even show me before and after photos of the surgery, though, he did show me what the scar looks like on his female patients.
Is there any reason why this technique is not as successful?

[Litlriki]

Some surgeons approach gynecomastia through a single incision by the areola.  I find this approach limiting, and in particular, I like to be able to do liposuction from a second angle to help get a smoother contour.  Your surgeon may be the best specialist in the hospital, and he may be quite skilled, but he may not do gynecomastia surgery very often.  It would be nice to see some photos of his results.  I'm not sure how you can find out his level of expertise.  In the US, it's pretty easy to ask around about a surgeon or to get information on the internet.  Culturally, I don't know how feasible that is in Shanghai, and having done a fellowship in Taipei, I'm aware of cultural differences that could present challenges in Chinese society due to respect for the surgeon and the taboo on questioning his authority.  You may have a better idea of how that will go over with your surgeon, and if you're comfortable asking, you should request the opportunity to look at pre- and post-op photos of his patients, and perhaps ask how often he does the surgery.

Good luck,

Rick Silverman

[DrBermant]

I am scheduled for surgery in Shanghai, China later this month. I've put this off for so long that I just want to get it done, and I don't want to spend thousands atop thousands traveling back to the states.
Anyway, the surgeon instructed me in the consultation that he would remove all fat and gland from the areolar incision. Can the tumescent procedure be performed in this manner? Prior to the consult I was told that this surgeon was the best specialist in the hospital, but he didn't even show me before and after photos of the surgery, though, he did show me what the scar looks like on his female patients.
Is there any reason why this technique is not as successful?

I perform almost all of my male chest contouring from a single very small incision at the edge of the areola. Yes, it does take more time, patience, and effort to produce even results and occasionally I also need to add a remote incision to assist in the contouring. But the juncture of the color change of the edge of the areola is such a good place to hide a scar, that it is well worth the efforts in my opinion.

I spent 6 months performing Plastic Surgery in China. From the many surgeons I was exposed to during my teaching / learning there, I found the Chinese are very good at documentation their results with before and after pictures. No pictures before and after male breast reduction should be a clue: a very obvious warning sign. Female Breast Reduction is a different type of surgical sculpture with different skills and techniques. Every surgeon needs to start somewhere. The question is who gets to be one of that surgeon's early efforts.

Saving money can be critical. However, Revision Gynecomastia Surgery can be much more expensive. In addition, some of the complications I have seen of poorly done surgery have no reasonable reconstructive option.

How to pick your gynecomastia surgeon:
http://www.gynecomastia.org/smf/index.php?topic=16474.0

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Dr. Elliot Jacobs]

Gyne surgery is quite different from female breast reduction surgery -- your plastic surgeon should be able to show you some photos to demonstrate some of his results on gyne patients.  Without those photos, I would be skeptical as to how many he has done.  And since gyne surgery requires its own expertise, I would look further for another opinion -- try to find another surgeon who is interested and experienced in this procedure.

As for incisions, this concern should be secondary.  Some physicians prefer one incision site over the other -- but all surgeons will carefully suture them.  And over time, the resultant scars, wherever they may be, will be insignificant compared to the very significant improvement of your overall chest contour.

Best of luck!

Dr Jacobs

[artichokeheart]

Thanks for your replies. I am cancelling the scheduled surgery. It's a much harder decision to cancel the procedure than it was to schedule it. I want to get it done so bad, but I'd hate to make hasty decision 3000 miles from home. But I have set up a consultation with a different surgeon. I am hoping he has documented his experience more than the last one.

[DrBermant]

Thanks for your replies. I am cancelling the scheduled surgery. It's a much harder decision to cancel the procedure than it was to schedule it. I want to get it done so bad, but I'd hate to make hasty decision 3000 miles from home. But I have set up a consultation with a different surgeon. I am hoping he has documented his experience more than the last one.

That is one of the advantages of picking a surgeon who can show their documented extended experience of gynecomastia surgery on the web. By the time my patients have their consultation or Preliminary Remote Discussion to minimize travel to Virginia, they can spend a great deal of time leaning about what I offer.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Dr. Elliot Jacobs]

When and if you might consider traveling for surgery, I would be pleased to offer a free email evaluation.  Just send me a PM with your name and email addy.

Dr Jacobs

[Dr. Cruise]

The number of gynecomasia procedures a surgeon performs is typically related to the population of patients he cares for.  I don't know if the population in China is concerned about gynecoamstia as they here in the United States, and particularly where I practice in Southern California.  

For this reason and due to the fact your surgeon does not provide before and after photos for example, I would have trepidation as to whether or not your plastic surgeon has much experience in the treatment of gynecomastia.  

Most experienced plastic surgeons who specialize in gynecomastia correction are set up to care for international patients.  My out of town patients will typically stay for as short as 3 days, thus limiting the actual total cost of travel to have the procedure.  Keep in mind, revisionary gynecoamstia correction can be more financially and emotionally costly than traveling to find an experienced plastic surgeon to perform the procedure.  This is not to say your plastic surgeon in China isn't capable, but you really must do your homework.